Lipid-Lowering Drug Use and Cancer Incidence and Mortality in the ARIC Study
Menée auprès de 12 997 participants (âge : 45-64 ans ; 55 % de femmes ; durée de suivi : 6 ans), cette étude multicentrique analyse l'association entre une utilisation de médicaments hypolipémiants et l'incidence ou la mortalité du cancer
Lipid-lowering drugs, particularly statins, are associated with reduced incidence of certain cancers in some studies. Associations with cancer mortality are not well studied, and whether associations are similar across race is unknown.We conducted a prospective analysis of 12,997 cancer-free participants in the Atherosclerosis Risk in Communities Study who were never users at visit 1 (1987-1989). Ever use, duration of use, and age at first use were modeled as time-dependent variables using Cox regression to estimate associations with total, obesity- and smoking-associated, and bladder, breast, colorectal, lung, and prostate cancer incidence and mortality.We ascertained 3,869 cancer cases and 1,661 cancer deaths in ≥ 237,999 person-years. At 6 years of follow-up, 70.8% of lipid-lowering drug use was a statin. Compared to never use, ever use was associated with lower total, obesity-, and smoking-associated cancer mortality, and with colorectal cancer mortality (hazard ratio [HR]=0.50; 95% confidence interval [CI]=0.32-0.79) and incidence (HR = 0.69; 95%CI=0.53-0.92). Inverse associations were consistent by sex and by race. Shorter-term use was associated with bladder cancer incidence in men (<10 years: HR = 1.67; 95%CI=1.02-2.73). First use at age ≥60 years was inversely associated with total, obesity- and smoking-associated, and colorectal cancer mortality, and total, obesity- and smoking-associated, breast, colorectal, and prostate cancer incidence.This study provides additional evidence for inverse associations between lipid-lowering drug use and cancer incidence and mortality, but a positive association with bladder cancer incidence in men. Evaluation of the impact of chemoprevention strategies that include lipid-lowering drugs on population-level cancer burden is needed.